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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 7 to 31 of 47. Go back in thread:
Posted by SLS on January 28, 2014, at 16:03:33
In reply to Re: Switching from Abilify to Latuda, posted by bleauberry on January 28, 2014, at 15:22:43
> Hanging in there with you Scott. I hope the transition goes as smooth as possible. You are such a strong and patient warrior I really wish for this new med to provide significant improvement in your quality of life.
Thanks, friend.
- Scott
Posted by SLS on January 28, 2014, at 16:05:02
In reply to Re: Switching from Abilify to Latuda » SLS, posted by phidippus on January 28, 2014, at 15:42:47
> You can go up to 160 mg on the Latuda, so 20-40 mg will likely be a small dose compared to the 10 mg you take of Abilify.
>
> Eric
Thanks, Eric. Good info. I am going to go with 40 mg/day for now.Take care.
- Scott
Posted by SLS on January 28, 2014, at 20:29:11
In reply to Re: Switching from Abilify to Latuda » SLS, posted by Phil on January 27, 2014, at 22:01:32
> good luck scott. i think my doctor will be going from seroquel to latuda. i've gained weight and developed dystonia on seroquel.
Thanks, Phil.
I am sorry that the Seroquel didn't work out for you. Good luck with the Latuda. I have a good feeling about this drug.
My tiglyderides on Abilify are way over 400. My main concern is health. Next comes vanity. I would love to start weight training again. I had my bench-press up to 265 lbs before having to give up for lack of energy and motivation. I was about 155 lbs at the time. Ah... Glory Days.
I don't recall ever asking you what condition or symptoms you have for which you are using an antipsychotic to treat.
- Scott
Posted by SLS on January 28, 2014, at 20:35:41
In reply to Re: Switching from Abilify to Latuda, posted by Phillipa on January 27, 2014, at 22:25:06
> Scott sounds like a good choice. Good luck Hope this is the magic bullet so to speak. Phillipa
Thanks, PJ
I can't rule-out the possibility that Latuda will work magic for me, but I must remain guarded in my optimism. If nothing else, it would be nice to feel as well on Latuda as I had on Abilify, but without high triglycerides and the extra 60 lbs.
- Scott
Posted by SLS on January 28, 2014, at 20:37:06
In reply to Re: Switching from Abilify to Latuda, posted by SLS on January 28, 2014, at 20:35:41
Posted by Phillipa on January 28, 2014, at 20:42:00
In reply to Re: Switching from Abilify to Latuda, posted by SLS on January 28, 2014, at 20:35:41
Scott what ever happened to the site you had? And you had the pics of you lifting. That would also be motivation to start again? PJ
Posted by Twinleaf on January 28, 2014, at 20:50:48
In reply to Re: Switching from Abilify to Latuda, posted by SLS on January 28, 2014, at 20:35:41
Do hope it works. I can't remember, but would Metformin and/or Lipitor be a help if you are going to continue on an AP?From the little I know, Latuda has less effects than the other APs, but still, you do have to think about Metabolic Syndrome
Posted by SLS on January 28, 2014, at 20:55:18
In reply to Re: Switching from Abilify to Latuda » SLS, posted by Phillipa on January 28, 2014, at 20:42:00
> Scott what ever happened to the site you had? And you had the pics of you lifting. That would also be motivation to start again? PJ
Yes. I still have my bodybuilding pictures up. I would like to resume exercise soon. My focus would be more on strength and conditioning rather than on physique. Still, it would be nice to be a head-turner again. Actually, I am still a head-turner. The only problem is that I see heads turn away.
:-(
- Scott
Posted by SLS on January 28, 2014, at 20:58:31
In reply to Re: Switching from Abilify to Latuda » SLS, posted by Twinleaf on January 28, 2014, at 20:50:48
I am going to ask my doctor for metformin. I had thought about bringing a statin on board, too. I'm thinking that I would have more luck asking my PCP for these things.
Thanks for the great suggestions.
- Scott
Posted by Phil on January 29, 2014, at 1:42:20
In reply to Re: Switching from Abilify to Latuda » Phil, posted by SLS on January 28, 2014, at 20:29:11
Last time I checked he had me at bipolarI but i'm not sure why because the few criteria I don't meet. I'll ask him at my next appt.
My worst enemy right now are hypnagogic hallucinations. As one guy said, they are vivid and terrifying. i went to bed 3 hours ago. I got up an hour ago because I'm scared sh*tl*ss of what i'm going to see or hear or both next. it's 140am, i'll try again.
265!
Posted by Bob on January 29, 2014, at 12:45:50
In reply to Re: Switching from Abilify to Latuda, posted by SLS on January 28, 2014, at 20:35:41
I've been on Latuda for a little over a month now. For the first few weeks it went well and I experienced a nice focus and lift of spirits. I actually felt old interests rekindling and it was totally unexpected. In the last week or two however that seems to have disappeared rather suddenly. I had leveled off at about 40mg but am reticent to take it higher as my mood and wit now seem to be dulled and my affect is flat. Not sure whether to wait longer or do something.Bob
Posted by Bob on January 29, 2014, at 12:53:36
In reply to Re: Switching from Abilify to Latuda » SLS, posted by Bob on January 29, 2014, at 12:45:50
Latuda also seems to be causing fatigue and has totally crushed my sexuality -- not that it wasn't almost gone already with my base cocktail of nortriptyline and sertraline.I've tried adding Wellbutrin as well as Nuvigil but both don't have sustainable benefits for me.
Bob
Posted by SLS on January 29, 2014, at 14:02:00
In reply to Re: Switching from Abilify to Latuda » Bob, posted by Bob on January 29, 2014, at 12:53:36
>
> Latuda also seems to be causing fatigue and has totally crushed my sexuality -- not that it wasn't almost gone already with my base cocktail of nortriptyline and sertraline.
>
> I've tried adding Wellbutrin as well as Nuvigil but both don't have sustainable benefits for me.
>
> BobThat is not an optimistic report. :-(
Why are you taking an antpsychotic?
Have you tried Abilify?
Right now, I am pleasantly surprised that I have not dropped off for having discontinued Abilify. I don't know. Perhaps Latuda is making an effective substitute. I am not feeling too much better, but I don't think I am feeling worse. I thought I needed the dopamine activation provided by Abilify when treating depression (DA D2/D3 partial agonist). I really thought that I would significantly relapse. It's still early yet, of course, but I am hoping for magic. Latuda is not a DA partial agonist, but it is a 5-HT7 receptor antagonist. Recently, this receptor has been the focus of interest in accounting for the antidepressant effects of Latuda.
I hope you are experiencing a temporary setback. Who knows what your brain is up to. Have you ever tried Focalin for fatigue / brain fog? It helps me when my energy ebbs. If it is a good drug for you, you won't experience a depressive rebound when it wears off. For now, I am using it occasionally in place of caffeine. My doctor prescribed it to be taken on a daily basis in the hope that it will kick-start a robust antidepressant response. I want to see how Latuda treats me first.
Please continue posting.
Me:
Parnate 100 mg/day
nortriptyline 150 mg/day
Lamictal 200 mg/day
lithium 450 mg/day
Latuda 40 mg/day
prazosin 25 mg/day
minocycline 200 mg/day
- Scott
Posted by Bob on January 29, 2014, at 14:11:14
In reply to Re: Switching from Abilify to Latuda » Bob, posted by SLS on January 29, 2014, at 14:02:00
> >
> > Latuda also seems to be causing fatigue and has totally crushed my sexuality -- not that it wasn't almost gone already with my base cocktail of nortriptyline and sertraline.
> >
> > I've tried adding Wellbutrin as well as Nuvigil but both don't have sustainable benefits for me.
> >
> > Bob
>
> That is not an optimistic report. :-(
>
> Why are you taking an antpsychotic?
>
> Have you tried Abilify?
>
> Right now, I am pleasantly surprised that I have not dropped off for having discontinued Abilify. I don't know. Perhaps Latuda is making an effective substitute. I am not feeling too much better, but I don't think I am feeling worse. I thought I needed the dopamine activation provided by Abilify when treating depression (DA D2/D3 partial agonist). I really thought that I would significantly relapse. It's still early yet, of course, but I am hoping for magic. Latuda is not a DA partial agonist, but it is a 5-HT7 receptor antagonist. Recently, this receptor has been the focus of interest in accounting for the antidepressant effects of Latuda.
>
> I hope you are experiencing a temporary setback. Who knows what your brain is up to. Have you ever tried Focalin for fatigue / brain fog? It helps me when my energy ebbs. If it is a good drug for you, you won't experience a depressive rebound when it wears off. For now, I am using it occasionally in place of caffeine. My doctor prescribed it to be taken on a daily basis in the hope that it will kick-start a robust antidepressant response. I want to see how Latuda treats me first.
>
> Please continue posting.
>
> Me:
>
> Parnate 100 mg/day
> nortriptyline 150 mg/day
> Lamictal 200 mg/day
> lithium 450 mg/day
> Latuda 40 mg/day
> prazosin 25 mg/day
> minocycline 200 mg/day
>
>
> - Scott
>
>
>
Don't take my report of response to mean anything for you. We are very different in terms of med tolerance and effect I believe.I am trying to augment my nortriptyline/sertraline combination to kickstart my response. I have tried all the stim class meds, including dexmethylphenidate. They all have an unreliable and troublesome response for me. As time goes on it's getting to be less and less. This always happens with every single medication I have ever tried that worked for any amount of time. Nothing lasts anymore and things which initially provided a response in the past are proving less and less effective.
Bob
Nortriptyline: 225mg (as close to 150ng/ml as possible)
Sertraline: 75mg
Lurasidone: 40mg
Posted by Bob on January 29, 2014, at 14:17:18
In reply to Re: Switching from Abilify to Latuda » Bob, posted by SLS on January 29, 2014, at 14:02:00
> >
> > Latuda also seems to be causing fatigue and has totally crushed my sexuality -- not that it wasn't almost gone already with my base cocktail of nortriptyline and sertraline.
> >
> > I've tried adding Wellbutrin as well as Nuvigil but both don't have sustainable benefits for me.
> >
> > Bob
>
> That is not an optimistic report. :-(
>
My doctor will not touch the MAOI+nortriptyline combo that you are taking. He says mixing NRIs with MAOIs is dangerous. What about stimulants, are they okay to take with an MAOI?
> Why are you taking an antpsychotic?
>
> Have you tried Abilify?
>
> Right now, I am pleasantly surprised that I have not dropped off for having discontinued Abilify. I don't know. Perhaps Latuda is making an effective substitute. I am not feeling too much better, but I don't think I am feeling worse. I thought I needed the dopamine activation provided by Abilify when treating depression (DA D2/D3 partial agonist). I really thought that I would significantly relapse. It's still early yet, of course, but I am hoping for magic. Latuda is not a DA partial agonist, but it is a 5-HT7 receptor antagonist. Recently, this receptor has been the focus of interest in accounting for the antidepressant effects of Latuda.
>
> I hope you are experiencing a temporary setback. Who knows what your brain is up to. Have you ever tried Focalin for fatigue / brain fog? It helps me when my energy ebbs. If it is a good drug for you, you won't experience a depressive rebound when it wears off. For now, I am using it occasionally in place of caffeine. My doctor prescribed it to be taken on a daily basis in the hope that it will kick-start a robust antidepressant response. I want to see how Latuda treats me first.
>
> Please continue posting.
>
> Me:
>
> Parnate 100 mg/day
> nortriptyline 150 mg/day
> Lamictal 200 mg/day
> lithium 450 mg/day
> Latuda 40 mg/day
> prazosin 25 mg/day
> minocycline 200 mg/day
>
>
> - Scott
>
>
>
Posted by Bob on January 29, 2014, at 15:24:49
In reply to Re: Switching from Abilify to Latuda, posted by Bob on January 29, 2014, at 14:17:18
I've tried pretty much all of the atypicals with varying results, but none provided a great response. Abilify probably helped the most although I eventually had trouble tolerating it. I was fearful of staying on any of them too long because of the weight-gain and diabetic issues -- especially Zyprexa and Abilify. Seroquel and Risperdal were pretty sedating and also caused weight-gain.
Posted by SLS on January 29, 2014, at 16:47:41
In reply to Re: Switching from Abilify to Latuda, posted by Bob on January 29, 2014, at 14:17:18
> My doctor will not touch the MAOI+nortriptyline combo that you are taking. He says mixing NRIs with MAOIs is dangerous. What about stimulants, are they okay to take with an MAOI?
http://www.dr-bob.org/tips/split/TCAs-+-MAOIs.html
http://www.dr-bob.org/tips/split/MAOIs-in-high-doses-and-wi.html
:-)
- Scott
Posted by SLS on January 30, 2014, at 11:45:52
In reply to Switching from Abilify to Latuda, posted by SLS on January 27, 2014, at 21:32:51
So far, so good.
I'm 4 days into Latuda without taking any Abilify. I haven't relapsed. I like the way I feel on Latuda. It isn't magic, but it might be better than Abilify. It is early. I'm taking 40 mg/day of Latuda. There are no side effects. I was particularly concerned with cognitive blunting and zombification (not official medical nomenclature).
I am trying to be guarded in my optimism. I am failing.
- Scott
Posted by Bob on January 30, 2014, at 14:34:22
In reply to Re: Switching from Abilify to Latuda » Bob, posted by SLS on January 29, 2014, at 16:47:41
> > My doctor will not touch the MAOI+nortriptyline combo that you are taking. He says mixing NRIs with MAOIs is dangerous. What about stimulants, are they okay to take with an MAOI?
>
> http://www.dr-bob.org/tips/split/TCAs-+-MAOIs.html
>
> http://www.dr-bob.org/tips/split/MAOIs-in-high-doses-and-wi.html
>
> :-)
>
>I've shown my pdoc articles and postings about mixing the MAOIs with NRIs or stims and he isn't moved. He just isn't willing.
> - Scott
Posted by Bob on January 30, 2014, at 14:37:16
In reply to Re: Switching from Abilify to Latuda, posted by SLS on January 30, 2014, at 11:45:52
> So far, so good.
>
> I'm 4 days into Latuda without taking any Abilify. I haven't relapsed. I like the way I feel on Latuda. It isn't magic, but it might be better than Abilify. It is early. I'm taking 40 mg/day of Latuda. There are no side effects. I was particularly concerned with cognitive blunting and zombification (not official medical nomenclature).
>
> I am trying to be guarded in my optimism. I am failing.
>
>
It's stunning to hear you've had no discontinuation effects from stopping the Abilify like that! Then again you are not one to have experienced such things, correct? For me, micro-adjustments to my aripiprazole dose resulted in bad days and suicidality. My sister stopped Abilify last year and it almost took her life. She's off it now.Bob
> - Scott
Posted by Bob on January 30, 2014, at 14:40:46
In reply to Re: Switching from Abilify to Latuda » Bob, posted by SLS on January 29, 2014, at 14:02:00
>
> I hope you are experiencing a temporary setback. Who knows what your brain is up to. Have you ever tried Focalin for fatigue / brain fog? It helps me when my energy ebbs. If it is a good drug for you, you won't experience a depressive rebound when it wears off. For now, I am using it occasionally in place of caffeine. My doctor prescribed it to be taken on a daily basis in the hope that it will kick-start a robust antidepressant response. I want to see how Latuda treats me first.
>
> - Scott
>You said you are using the Focalin occasionally, so how often and under what circumstances are you taking it if not daily? How long have you been doing this?
What about Wellbutrin? I've don't remember you mentioning ever trying that or having it on your options list.
Bob
>
>
Posted by Bob on January 31, 2014, at 12:42:15
In reply to Re: Switching from Abilify to Latuda » SLS, posted by Bob on January 30, 2014, at 14:40:46
One more question Scott:I noticed you still have the minocycline on board. Do you still attribute discrete, definable benefits of your response to that med in particular? If so, what are they exactly?
Bob
Posted by SLS on January 31, 2014, at 13:39:39
In reply to Re: Switching from Abilify to Latuda » SLS, posted by Bob on January 30, 2014, at 14:37:16
> > So far, so good.
> >
> > I'm 4 days into Latuda without taking any Abilify. I haven't relapsed. I like the way I feel on Latuda. It isn't magic, but it might be better than Abilify. It is early. I'm taking 40 mg/day of Latuda. There are no side effects. I was particularly concerned with cognitive blunting and zombification (not official medical nomenclature).
> >
> > I am trying to be guarded in my optimism. I am failing.
> >
> >
>
>
> It's stunning to hear you've had no discontinuation effects from stopping the Abilify like that! Then again you are not one to have experienced such things, correct?Not really. Although I need and can tolerate high dosages of many drugs, that doesn't seem to indicate that withdrawal effects are significantly reduced whenever I discontinue a medication. The last time I attempted to discontinue Abilify by tapering, I still experienced a wicked withdrawal depressive rebound that lasted for a few days before evening out. This time, I stopped the Abilify abruptly and began taking Latuda at 40 mg/day on the same day. I felt only a slight loss of antidepressant activity on day 3 that lasted for about 6 hours. I could "feel" the Latuda breaking my fall (speculation, I know). It is important to note that the half-life of Abilify is 3 days. So, blood levels of Abilify came down more slowly than what would be seen with most other psychotropic medications.
> For me, micro-adjustments to my aripiprazole dose resulted in bad days and suicidality. My sister stopped Abilify last year and it almost took her life. She's off it now.
In many cases, the depressive/anxiogenic rebound effect from discontinuing a psychotropic is transient, but can be mitigated by performing a gradual taper. Even this doesn't always work to prevent entirely the withdrawal effects. However, it should reduce their in duration and magnitude.
- Scott
Posted by SLS on January 31, 2014, at 13:53:00
In reply to Re: Switching from Abilify to Latuda » SLS, posted by Bob on January 30, 2014, at 14:40:46
> > I hope you are experiencing a temporary setback. Who knows what your brain is up to. Have you ever tried Focalin for fatigue / brain fog? It helps me when my energy ebbs. If it is a good drug for you, you won't experience a depressive rebound when it wears off. For now, I am using it occasionally in place of caffeine. My doctor prescribed it to be taken on a daily basis in the hope that it will kick-start a robust antidepressant response. I want to see how Latuda treats me first.
> You said you are using the Focalin occasionally, so how often and under what circumstances are you taking it if not daily? How long have you been doing this?
Focalin helps with mental and physical energy, but not with depression per se. However, with more mental resources to work with, the depression is easier to negotiate and tolerate. I was prescribed Focalin to be taken twice a day, every day. He said that if I got euphoric and suffered a depressive crash, it was the wrong drug for me. We hoped that it might kick-start the other medications to begin working better. Ideally, I would then be able to discontinue the Focalin at some point.
Focalin worked for me the way my doctor was hoping it would at first, but just not to a degree that I was satisfied with. I therefore decided to use it more as a PRN and remain flexible. I would say that there was some tolerance that developed at the dosage I used, but it was not a complete waste of time to take it. I thought that to use Focalin acutely only for particularly difficult days would preserve a more robust stimulant effect than taking it continuously.
> What about Wellbutrin? I've don't remember you mentioning ever trying that or having it on your options list.I have tried Wellbutrin several times beginning in 1983 at dosages as high as 900 mg/day. Each time, it made me feel moderately worse, even when combined with Parnate.
- Scott
Posted by SLS on January 31, 2014, at 14:11:49
In reply to Re: Switching from Abilify to Latuda » Bob, posted by Bob on January 31, 2014, at 12:42:15
> One more question Scott:
Yeah sure...
:-)
> I noticed you still have the minocycline on board. Do you still attribute discrete, definable benefits of your response to that med in particular? If so, what are they exactly?
I tried to discontinue minocycline once. I had been taking it for 6 months at that time. I relapsed within two days. Fortunately, I felt better quickly after restarting it. The scope of the improvements produced by minocycline are more global than being selective of only a few symptoms.
Get well!!!
- Scott
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